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Jurisprudence of Medicine Q: is it permissible for a doctor (in medicine) to disclose his patients secrets?

A: If patients entrust the doctor with their secrets, such secrets must be kept the same way a trust of money is kept, perhaps keeping a secret is more important than keeping money because the former leads to enormous negative consequences on the part of the trustee. Moreover, in some traditions, it is reported that the privacy of a meeting must not be encroached, and no one is authorized to disclose a secret hidden by his fellow human being unless it is for his own good; We can even say that if a patient tells his secrets to his doctor due to health needs, provided that the doctor doesnt disclose such secrets to anybody else, then the doctor is not allowed to reveal such secrets, especially if a defect, whether physical or moral, is included. Otherwise, this will be considered backbiting, which means uncovering your brothers hidden defects. Q: Is it permissible for a woman to consult a male gynecologist who is more experienced and knowledgeable than other available female gynecologists? A: If both the male and the female gynecologists are equally qualified concerning medical and scientific abilities and methods of treatment, then a woman is not allowed to uncover her body to a male doctor, but if the male doctor is more lenient and experienced in treatment than other female doctor due to his advanced medical equipments or his lenient style of treating women- especially if the woman fears health damage if examined by a female doctor- then this woman is allowed to consult a male doctor even in the presence of female doctors. This has been stated by a tradition concerning this issue, which authorizes women to be examined by a male doctor if he is more lenient and experienced in treatment. This has also been highlighted by Imam Muhammad al Baqir(a.s.) as reported by Abu Hamza Al Thamali, who said: I asked the Imam whether a male doctor, who is more lenient in treating women than female doctors, can examine the body of a Moslem woman which is afflicted with defects, such as fractures and injuries in parts which are taboos. The Imam (a.s.) said: only if a male doctor is a necessity. The Second Martyr quoted this report and other reports to deduce that in treatment the rational sick people seek the most lenient and the most experienced to avoid harm, thus it is allowed in this case only. Q: What legal limitations and restraints should gynecologists abide by? A: Any physician or gynecologist is not allowed to look at the private parts of a womans body unless urgent treatment is necessitated. What is legally shown of the womans body is what could be revealed to both ordinary men and physicians for, in general, a man is not allowed to look at the body of a woman except for urgent treatment. On the other hand, any ordinary person and any physician can view a womans body in case of emergency, such as drowning or fire. Q: Upon delivery, is it permissible for a woman to resort to a male obstetrician in the presence of a midwife? What if the male obstetrician only controls the operation live through a television screen? A: Delivery is similar to any treatment, so if a woman can give birth with the assistance of a specialized midwife fearing no potential damage or disconcertion, then this woman is not allowed to resort to a male obstetrician to avoid the exposure. But this is permissible only in emergency cases when the supervision of an obstetrician is a must to assist the midwife upon delivery. Q: Is the doctors diagnosis of a patients case regarding fasting and other duties binding? What if the patient doubts the doctors belief and religious commitment? A: We can rely on the diagnosis of an experienced and trustworthy doctors to determine whether harm is potential or not. But if a doctor in not trustworthy, a patient can decide whether to break his fast or not depending on the degree of his fear of harm: if the doctors warnings cause great fear of harm, then the patient must break his fast, because breaking ones fast is determined by the fear of potential harm, not by the actual harm. On the other hand, if the doctors warnings dont lead to great fear of harm on the part of the patient, then he isnt allowed to break his fast, on the basis of the above-mentioned rule. Q: Is a doctor allowed to prescribe a medicine containing harmful elements to presumably relieve his patients pain? A: This is permissible if the patients pain is so unbearable that pain relief has become a priority if compared to the expected harm of the medicine But if the mentioned medicine causes the patients body to be afflicted with great damage or deformity, which might expose the patients life to danger, then it is impermissible... 1

Q: In some surgeries like loop setting, which are still controversial among jurists, should the doctor abide by the Jurist whom he follows or by the Jurist followed by his patient? A: Naturally, the doctor is to follow the jurist whom he follows, because what is he going to do is a part of his job for which he is responsible. For instance, if a woman-who follows those who permit women to look at the private parts of one another -resorts to a female doctor who follows those who forbid such an act, then the female doctor is allowed to treat this woman only in emergency cases. But if the female doctor follows a jurist whose Fatwas or opinions didnt discuss such a matter, than the doctor is permitted to treat the woman. Euthanasia (Mercy Killing) Q: By whom is Mercy killing determined: the doctor, the religious authority or the patient himself? A: If mercy killing means relieving a patients unbearable pain, then its impermissible, because putting an end to mans life is illegal even if it is based on pity and sympathy. And if mercy killing means putting an end to a patients life to comfort his parents on the basis that he is going to die in the coming few days, then its also impermissible because we are not authorized to rob him of his life even if one hour of survival is possible. On the other hand, if mercy killing means brain death, when the patient is considered medically dead and when the possibility of the brains re-functioning is less than one percent, then we can say that it is not a must to use the apparatus that elongates the bodys life represented by the heart movement. So, its lawful to remove this device should the concerned doctor so decide. Its also the duty of the parents to authorize the doctor to carry out the operation, for the doctor is not authorized to put an end to this mans life since the patient has a guardian, whom the doctor should refer to. This is based on the belief that the obligation of saving a patients life doesnt include the life of cells, but the life of the human being. This type of life, that of the cells, can be compared to a similar type of life in a snake tail after the snake is killed Q: In the two cases mentioned above, is it permissible for the patient to put an end to his life by asking the doctor to kill him? A: The patient is not allowed to do so, because he is not authorized to put an end to his life. Q: What is your judgment concerning the dissection of a dead body whether for educational reasons or for the diagnosis of death causes? A: In principle, it is not permissible to dissect the dead body of a Moslem because the sanctity of the dead believer is by no means inferior to the living one. Also God (praise be to Him) forbids any harm to the believer whether dead or alive as mentioned in many traditions. The Islamic law has imposed indemnity for cutting a dead bodys head, hand, etc But if learning in largely dependent on dissecting a dead Moslems body, then it will be permissible. For example, postmortem examination that leads to saving or treating many people, or to confirming the right of the dead or to knowing whether his death was not natural then it is legal because it represents a vital interest that surpasses the sanctity of the dead body. This is based on preferring the more important interest to a lesser one. Q: Its noticed that the majority of opinions that tend to forbid dissection refer to traditions that disallow mutilation-even to the mordacious dog. Its also obvious that there is a great difference between the current method of dissection and the idea of mutilation what is your judgment? A: Some jurists believe that mutilation occurs when a corpse is dismembered, regardless of the intentions, good or bad, whereas others believe that mutilation is a connotation of torture, revenge or punishment, and I tend to adopt this opinion, thus, I believe that dissection for justified purposes is not considered mutilation. Q: What is your Eminences judgment concerning the donation of body organs after death? A: legally speaking, one has the right to donate his organs after death, because forbidding such an act is based on respecting him and his organs, so this is legal if he abandons this right after death through a will, especially if these organs save the lives of others or enable them to be more effective and active. In this respect, organ donation is characterized by charity and benevolence, which are highly commanded, as in Allahs say {And they prefer (them) before themselves though poverty may afflict them}[59:09] Through this verse, we derive the legitimacy of preference although it talks about money, since it establishes the principle of preference. Q: If a persons life is urgently dependent on an organ from a dead body, what is the legal judgment? 2

A: Its not only permissible but it is a must even if it is not mentioned in the will, because preserving a Moslems life is more important than observing the sanctity of a dead body. Q: Is it permissible for a female nurse assigned to take care of a male patient to touch him or to see his private part? A: This is impermissible in origin unless his treatment is largely dependent on that, and unless she is the only person present to carry out this task. Q: What is the legal rule concerning abortion? What about the operating doctor? A: Abortion is illegal once the spermatozoon impregnates the ovum and once life is infused in the womans womb... Thus, this is legal only in special cases as when the fetus endangers the mothers life, then, the mother is allowed to defend herself even if the source of danger is not aware of what he is doing, like in the case of a mad man or the like. Q: Is it rewarding to donate blood to non-Muslims? A: its said that it is rewarding to answer any call for help, so saving others lives, including non-Muslims is commended by God. In addition, such an act helps spread Islam and confirms the morality of the Muslim, who does others favors, no matter to what religion they belong. Q: As a doctor, can I hide a patients medical information or diagnosis to avoid psychological harm? Am I allowed to give him a false hope to boost his morale? A: It is not permissible to tell a patient about his illness if it speeds up his death unless not informing him leads to great disadvantage, before which he must take care of some important errands that would lead to great harm if they were not accomplished. On the other hand, giving him a false hope in an indirect way to heighten his spirits is highly rewarding. Q: What is your comment on the hymen repair surgery, for woman who lost her virginity, in accident or by a mistake, to deceive her husband and to escape from grave social persecution? A: This is permissible, if the loss virginity leads her to suffer unbearable disgrace, disrepute or death. But, this should be done with great care and reservation and only in critical situations, for encouraging this kind of operations may lead a lot of woman to sexually deviate and find it easy to indulge in relationships, even the legal ones as in temporary marriages, which might result in some moral corruption or social problems. As far as deception is concerned, if a husband finds out that his wifes virginity is restored, then he has the right to accuse his wife of deception. Thus its recommended that the husband be told about loss virginity before marriage, so that matrimonial life will be based on mutual trust, which stabilizes marriage foundations. Q: Is it permissible for a woman to have abortion if her pregnancy is the outcome of a secret marriage or an illegal sexual relation in order to escape from danger or grave social persecution? A: This is permissible if her conception endangers her life or often leads to unbearable disgrace and disconcertion, provided that the embryo has not reached the stage that could be called alive; otherwise, abortion is illicit unless it is necessitated by tangible danger to a woman life. Q: If a mothers survival depends on her fetuss demise or vise versa, whose life is given priority? Is the decision determined by the mother, the husband, the doctor, or the religious authority? A: The mother has the right to make the decision and to defend herself by abortion. Nobody else, whether a doctor, the babys or the mothers guardian, can interfere to solve the problem, but the religious authority can interfere only to ratify the legitimacy of the mothers decision. However, the doctor is allowed to perform abortion only if the womans life is dependent on this operation, without which her life will be in a real danger. Its worth mentioning that maximum reservation should be considered in such cases.